JEROME R WALDBAUM (NPI# 1689610602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689610602 |
| Entity Type | Individual |
| Full Name | JEROME R WALDBAUM |
| Credential | MD |
| Practice Address |
4225 Hoyt Ave Suite A Everett WA 98203-2351 |
| Practice Telephone | 4252593122 |
| Mailing Telephone | 4252593122 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2008-01-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
MD00020538 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LABOR AND INDUSTRY | 0037731 | 01 |
| WA | 8483505 | 05 | |
| WA | STATE LICENSE NUMBER | MD00020538 | 01 |
| Street Address |
4225 HOYT AVE SUITE A |
| City | EVERETT |
| State | WA |
| Zip Code | 98203-2351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396729745 | William Patrick Brust | Dentist | 4225 Hoyt Ave, Ste D, Everett, WA 98203-2318 | 2005-11-30 |
| 1902108046 | Aaron D Wright Dmd Ps | Dentist | 4225 Hoyt Ave, Suite D, Everett, WA 98203-2351 | 2010-11-22 |
| 1194967661 | Precision Endodontics, Pllc | Dentist | 4225 Hoyt Ave, Suite B, Everett, WA 98203-2351 | 2009-03-30 |
| 1841446655 | Maiyen Tran Hawkins | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2008-08-12 |
| 1285840744 | Joy Angelique Rivero | Dentist | 4225 Hoyt Ave, Suite B, Everett, WA 98203-2351 | 2007-05-14 |
| 1760694186 | Eduardo Alvarez Chua | Internal Medicine | 4225 Hoyt Ave, Ste A, Everett, WA 98203-2351 | 2007-05-06 |
| 1386680445 | Sujoy K Ghorai | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-20 |
| 1942241104 | W Michael Mcdonnell | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-09 |
| 1841231438 | James Mu | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-08 |
| 1760423388 | Friedrich Loura | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226039 | Lisa Mcgregor | Counselor | Sea Mar Community Health Centers, 5007 Claremont Way, Everett, WA 98203 | 2020-08-20 |
| 1417572009 | Megan Ostermick-durkee | Student in an Organized Health Care Education/Training Program | Sunrise Services Inc., 811 Madison Street, Everett, WA 98203 | 2020-06-10 |
| 1134741424 | Tara Lin Garcia | Peer Specialist | 4256 Federal Avenue, Everett, WA 98203 | 2020-05-11 |
| 1225505241 | Reverie Aurora Shunny | Counselor | Sunrise Service Inc., 811 Madison Street, Everett, WA 98203 | 2018-10-29 |
| 1205313483 | Kristina Renee Bylenga | Counselor | Compass Health 4526 Federal Avenue M/s # 11, Everett, WA 98203 | 2018-07-20 |
| 1306384300 | Shantijoy Inc | Naturopath | 5208 S 2nd Ave, Everett, WA 98203 | 2017-02-09 |
| 1922545276 | Ekaterina Malinovska Dds Pllc | Dentist | 5920 Evergreen Way Suite E, Everett, WA 98203 | 2017-01-25 |
| 1326404104 | Job Oichoe | Counselor | 4625 Federal Ave, Everett, WA 98203 | 2016-01-08 |
| 1427423292 | Ross Lee Voorhees | Counselor | 4423 S 3rd Ave, Everett, WA 98203 | 2015-12-04 |
| 1447642376 | Adam Schneider | Counselor | 4526 Federal Ave # 40, Everett, WA 98203 | 2015-03-02 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023236528 | Western Washington Medical Group, Inc Ps | Internal Medicine | 4225 Hoyt Ave Ste A, Everett, WA 98203-2351 | 2007-04-23 |
| 1699743427 | Madan Lal Zutshi | Internal Medicine | 92 Garland St, Everett, MA 02149 | 2006-03-09 |
| 1336376441 | Dhavan A Parikh | Internal Medicine | 3927 Rucker Ave, Everett, WA 98201-4833 | 2009-06-16 |
| 1649419698 | Jianfeng Cheng | Internal Medicine | 3927 Rucker Ave, Everett, WA 98201-4833 | 2009-02-16 |
| 1376707232 | Madan Zutshi, P.C. | Internal Medicine | 92 Garland St, Everett, MA 02149-5067 | 2008-07-10 |
| 1760694186 | Eduardo Alvarez Chua | Internal Medicine | 4225 Hoyt Ave, Ste A, Everett, WA 98203-2351 | 2007-05-06 |
| 1760584452 | Janet C King | Internal Medicine | 3927 Rucker Ave, Everett, WA 98201-4833 | 2006-09-02 |
| 1295842037 | Darby E Robinson O'neill | Internal Medicine | 3927 Rucker Ave, Everett, WA 98201-4833 | 2006-08-25 |
| 1386680445 | Sujoy K Ghorai | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-20 |
| 1942241104 | W Michael Mcdonnell | Internal Medicine | 4225 Hoyt Ave, Suite A, Everett, WA 98203-2351 | 2006-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.